Other Possible Causes Of Hand Pain
Hand pain is also a sign of Dupuytrens contracture, a condition in which the tissue of the palm and fingers becomes thickened and tight, causing the fingers to curl inward. Its not clear why Dupuytrens contracture develops, though those who smoke, drink a lot of alcohol, and have seizures or diabetes are more vulnerable to developing it.
Your doctor will also consider whether your hand pain could be due to carpal tunnel syndrome, says Dr. Byram. RA can be a cause of carpal tunnel syndrome, so if we see someone who has carpal tunnel, well want to make sure they dont have RA. Carpal tunnel is a condition that occurs when one of the major nerves to the hand the median nerve is squeezed or compressed as it travels through the wrist, according to the American Academy of Orthopaedic Surgeons.
Changes In Surrounding Joints
In patients with advanced thumb base arthritis, the neighboring joints may become more mobile than normal.
Thumb extension deformity. This patient has lost mobility at the base of the thumb due to arthritis. The next joint closer to the tip of the thumb has become more mobile than normal to make up for the arthritic joint. Normally, the thumb does not come to a right angle with the rest of the hand.
Hand Deformities From Rheumatoid Arthritis
Evidence suggests that hand deformities commonly occur in the first year of rheumatoid arthritis if it goes untreated.2Johnsson PM, Eberhardt K. Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology . 2009 48:13981401. doi:10.1093/rheumatology/kep253 Moreover, people who experience hand deformities in the first year tend to have more severe cases of the disease. 3Tubiana R, Toth B. Rheumatoid arthritis: clinical types of deformities and management. In: Wynn Parry CB, ed. Clinics in rheumatic diseases Vol. 5. Philadelphia: WB Saunders, 1984:2147. As cited in Johnsson PM, Eberhardt K. Hand deformities are important signs of disease severity in patients with early rheumatoid arthritis. Rheumatology . 2009 48:13981401. doi:10.1093/rheumatology/kep253
In some cases, hand deformities can be treated. In addition, new rheumatoid arthritis medications have reduced the likelihood that rheumatoid arthritis will cause permanent deformities.
The most common finger and wrist deformities are described below.
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What Are The Signs Of Arthritis In The Hands
May 19, 2021
Achy, swollen hands? Stiffness in your wrists? Its common to assume these are symptoms of arthritis. While 40 million Americans suffer from arthritis, its far less frequent in the hands than people expect. Instead, what many mistake for arthritis is actually tendonitis. Let’s look at the difference between arthritis and other conditions, risk factors and treatments.
Weight Management And Diet
Although the link between your weight and osteoarthritis of the hands may be less clear than for weight-bearing joints such as the knees, some research shows that being overweight increases inflammation and therefore pain. Therefore, if you have osteoarthritis of the hand or wrist, it still makes sense to try to maintain, or achieve, a healthy weight.
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Most People With Arthritis Are Under 65 Years Old
One of the reasons people assume arthritis is an inevitable consequence of aging is that the risk of developing the most common type of arthritis, osteoarthritis, increases with age. The risk of developing osteoporosis, a condition often confused with osteoarthritis, also increases with age. Yet, as the CDC points out, the majority of people with arthritis are under 65 years old.
Of people 18 to 44 years old, 7.1% report doctor-diagnosed arthritis, according to the CDC. Of people who are age 4564, 29.3% report doctor-diagnosed arthritis. In the 65 or older age group, 49.6% report doctor-diagnosed arthritis. While the risk of developing most types of arthritis increases with age, keep in mind that it is not the only contributing factor.
- Osteoarthritis onset usually occurs after the age of 40.
- Rheumatoid arthritis, an autoimmune inflammatory type of arthritis, can develop at any age.
- Systemic lupus erythematosus usually develops between infancy and old age, with a peak occurrence between 15 to 40 years of age.
- Fibromyalgia is typically diagnosed in middle age and prevalence increases with age.
- Childhood arthritis occurs in people up to 16 years of age.
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What Does Rheumatoid Arthritis In The Hands Feel Like
When your hands are affected by rheumatoid arthritis, you may experience swelling around the affected joint, which leads to pain or tenderness. The joint may feel warm to the touch. Swelling tends to be symmetrical, which means it occurs in the same joints on both right and left hands.
Stiffness with immobility is characteristic of rheumatoid arthritis in the hands as well, says Lindsay S. Lally, MD, a rheumatologist at Hospital for Special Surgery in New York City. Symptoms like stiffness and pain are usually worse in the morning, and can last at least 30 minutes or more.
Together these hand symptoms can impair function and the ability to go about your daily routine and tasks.
This can manifest in difficulty using the fingers, decreased hand dexterity, inability to bend or straighten affected joints, and decreased strength, says Dr. Albayda. Sometimes RA can cause loosening of ligaments and tendons in the hands, resulting in permanent deformities of the hand, adds Dr. Lally. Evidence suggests that hand deformities commonly occur in the first year of rheumatoid arthritis if it goes untreated.
Some specific hand problems and deformities that can be caused or made worse by rheumatoid arthritis include:
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How Ra Hand Pain Is Diagnosed
Theres no one test to diagnose RA and in its early stages, signs and symptoms can mimic those of many other diseases.
But early diagnosis of rheumatoid arthritis is important for the best outcome. We are learning that we need to control inflammation much more aggressively upfront as joint damage can ensue early on, says Dr. Albayda. Hence, there has been a shift in treatment paradigms to catching patients early and instituting treat-to-target control.
To help determine whether you have RA in your hand or wrist, a health care provider will examine your hands and fingers for such symptoms as:
- Joint instability
They will also ask questions about other symptoms that tend to go along with RA, such as fatigue, flu-like symptoms, fever, and disrupted sleep.
A health care provider may order imaging tests to check for certain characteristics of RA, such as narrowing of the joint space or erosions of the bone. They will run blood tests to look for antibodies that may be found in people with RA as well as elevated levels of markers of inflammation in the blood.
Here is more information about tests used for diagnosing rheumatoid arthritis and criteria used for diagnosing rheumatoid arthritis.
Treatment For Osteoarthritis Of The Hand
Treatment is designed to relieve pain and restore function. Anti-inflammatory or other analgesic medication may be of benefit in relieving pain. Brief periods of rest may help if the arthritis has flared up. You may also be advised to wear finger or wrist splints at night and for selected activities. Often soft sleeves may be of some benefit when the rigid splints are too restrictive, especially when the arthritis is affecting the joint at the base of your thumb. Heat modalities in the form of warm wax or paraffin baths might help, and when severe swelling is present, cold modalities may be of help. It is important to maintain motion in the fingers and use the hand as productively as possible. Hand therapy is often helpful with these exercises, splints, and modalities. A cortisone injection can often provide relief of symptoms, but does not cure the arthritis. Surgery is usually not advised unless these more conservative treatments fail.
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Other Conditions That Can Cause Hand Pain Include:
Carpal tunnel syndrome
Rheumatoid arthritis can raise your risk of this condition, but many other factors can contribute as well, including anatomy of your wrist, nerve-damaging diseases and possibly repetitive hand motions. Its tricky because you could have carpal tunnel syndrome that is related to RA or not at all related to RA.
Staying Physically Active Despite Hand Arthritis
Your doctor will tell you and probably has already that staying physically active is an important part of managing arthritis. In fact, according to a study of 5,715 adults with arthritis over age 65, a lack of regular, vigorous physical activity doubled the risk of functional decline. In other words, the less physically active the participants were, the more likely they were to become disabled.
Of course, despite data showing that physical activity helps people with arthritis become stronger and more flexible, anyone with arthritis will tell you that sometimes pain or stiffness makes it hard to get going, let alone lift weights at the gym. People with arthritis often give up activities they think of as optional, such as exercising or gardening, in order to have enough energy for the activities they feel obligated to do, such as cleaning the house. One study found that only 13 percent of men and 8 percent of women with arthritis met federal guidelines of at least 150 minutes of moderate-intensity activity per week.
If symptoms of arthritis in your hands or elsewhere are preventing you from participating in the physical activities you used to enjoy and that are good for you it may be time to find new ways to be active. For example, you may want to experiment with water activities such as swimming, or try tai chi, dance, or walking .
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What Is Osteoarthritis
Osteoarthritis is the most common form of arthritis, and the hand and wrist joints are among the most commonly affected. A joint is a part of the body where two or more bones meet. The ends of the bones are covered in a smooth and slippery surface, known as cartilage. This allows the bones to move smoothly against each other and protects the joint from stress.
Everyone’s joints go through a cycle of damage and repair, and often the repair process is quite effective. But sometimes it can cause changes in the shape or structure of the joints.
Osteoarthritis causes the cartilage in your joints to thin and the surfaces of the joint to become rougher, which means that the joints may not move as smoothly as they should, and they might feel painful and stiff.
You may have firm, knobbly swellings at the finger joints. These are known as Heberden’s nodes or Bouchard’s nodes depending on which joints are affected. They’re caused by the growth of bony spurs called osteophytes.
Osteoarthritis can affect anyone at any age, but it’s more common in women over the age of 50.
Some of the factors that can make you more likely to develop osteoarthritis in your hands include:
- carrying out repetitive tasks over a long period of time.
Should I See A Doctor
Its common to have aches and pains in your muscles and joints from time to time. This may especially be true if you take part in unusual or strenuous physical activities.
So, how can you tell the difference between the early signs of arthritis and normal pain and stiffness? And, how do you know when you should see a doctor about your symptoms?
If you have swelling or stiffness that you cant explain and that doesn’t go away in a few days, or if it becomes painful to touch your joints, you should see a doctor. The earlier you get a diagnosis and start the right type of treatment, the better the outcome will be.
Here are some other things to think about that might help you decide whether you need to see a doctor:
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How Will It Affect Me
The symptoms of hand osteoarthritis can vary between different people and over time. You’ll probably have good days and bad days. You may find this depends on what you’re doing, but sometimes there may not be any obvious reason.
If the joints are inflamed then they’re likely to look swollen and red and to feel warm and tender to the touch. You’re likely to have pain, especially when using your hands but sometimes even while resting. Swelling can also cause the soft tissues around a joint to stretch, which can make your hands feel weak or unstable.
As we use our hands such a lot in daily life, pain, stiffness or poor grip strength can cause problems with a wide variety of tasks and activities including:
- opening jars and cans
- holding a pen or cutlery
- doing up buttons or zips
- shaving, brushing your teeth, or drying yourself after a bath or shower.
Hand osteoarthritis often tends to ‘burn out’ after a time. It may be painful for a few years and then the pain may improve, especially if only the small finger joints are affected. Any firm, knobbly swellings or nodes that have developed will remain though. And the range of movement in the joints doesn’t always improve even when the pain does.
Sometimes the weather, especially cold weather, can make your symptoms worse. However, the weather won’t affect the long-term outlook or how the condition progresses.
Stick To Your Prescribed Rheumatoid Arthritis Treatment Plan
Medication that helps reduce out-of-control inflammation in the body is a cornerstone of rheumatoid arthritis treatment. Depending on the severity of your symptoms and how long youve had rheumatoid arthritis, your rheumatologist may prescribe a combination of medications. One of the major goals of treatment of RA is to prevent this structural damage that can result in loss of dexterity and strength in the hands, says Dr. Lally.
Commonly prescribed medications include:
Nonsteroidal anti-inflammatory drugs
These medications, such as ibuprofen or naproxen or prescription versions, are used for mild joint pain and reduce inflammation but dont prevent disease progression.
Glucocorticoids
These medications, such as prednisone, help reduce inflammation quickly and tend to be prescribed during flares. They used sparingly and carefully in people with RA because they can have a wide range of side effects.
Disease-modifying anti-rheumatic drugs
These medications address the underlying systemic inflammation in rheumatoid arthritis. They are critical for slowing and stopping the course of inflammatory disease. They fall into three general categories.
The treatments that we have for RA both the conventional DMARDs such as methotrexate and the biologics and JAK inhibitors can help improve joint pain, swelling, and stiffness while preventing the development of long-term damage, adds Dr. Lally.
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Malalignment Of One Or More Finger Joints
Over time, the destruction of bone and joint tissue may cause fingers and thumbs to become deformed. While the risk of hand deformities is significant, they are not inevitable.
A diagnosing physician will examine a patients hands, feet, and any other jointslarge or smallthat the patient reports as painful.
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What Type Of Hand Surgery Is Most Commonly Performed On The Specific Joints Affected By Arthritis
- Base of the thumb: Where your thumb and wrist join. Common surgical options include removing part or all of one of the trapezium bone , tendon transfer or joint fusion.
- Knuckles : Joint replacement is almost always considered for this repair. Rheumatoid arthritis can cause serious damage and disability to your knuckles.
- Second joint of your finger : Osteoarthritis commonly causes stiffness and loss of motion. Joint replacement or fusion are considered for these joints. Because you use these joints frequently, there is a chance your implant could wear out. In this case, your provider may recommend further surgery.
- Top of finger joint : Joint fusion is commonly used to treat arthritis in this joint.
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When To See A Healthcare Provider
If you suspect you may have RA or if you have any of the symptoms listed above, it is important to speak to your healthcare provider. As mentioned previously, RA can lead to significant issues in the lungs, eyes, nerves, and blood vessels. In fact, it may even lead to death overtime if left untreated.
Fortunately, RA can be effectively treated with the proper medication in a large percentage of individuals. Because of this, it is crucial to be evaluated by a qualified practitioner who is skilled in treating the disease.
How Hand Osteoarthritis Develops
Where bones meet to form a joint, their surfaces are covered with smooth, slippery cartilage. This cartilage provides a cushion between the small bones of the hand, protecting them from rubbing directly against each other. When this cartilage deteriorates, it is called osteoarthritis.
Exactly what causes cartilage to deteriorate is not clear to researchers,1 and may vary from person to person. The hands do not bear weight but its joints undergo stress on a daily basis, such as when carrying objects or gripping items. Aging and genetics also play roles.
As cartilage deteriorates, other changes in the hand also occur:
- Friction between bones can lead to the development of bone spurs .
- The bone underneath damaged or missing cartilage may develop cysts and areas of abnormal swelling called bone marrow lesions.
- The delicate membrane that encapsulates each small finger joint can become inflamed.
- The area where tendons insert into bone, called entheses, can also undergo inflammatory changes.
While bone spurs tend to be permanent, the other changes may get better or worse. They can lead to permanent damage or go away altogether.
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What Are The Different Types Of Arthritis In The Hand
Arthritis can be a debilitating disease, especially arthritis in your hands. Most people use their hands and fingers constantly throughout the day. Suffering from pain in your joints can make accomplishing any task that much harder. How does arthritis develop in your hands, what are the different types of arthritis, and are there treatment plans available to help? These are all great questions to ask yourself if you are experiencing pain, stiffness, or swelling in your joints.
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